良性前列腺增生症患者不同手术方式的医疗后果评价

摘要

目的 评价不同手术方式治疗良性前列腺增生症(BPH)患者的医疗后果,为临床治疗方案的选择提供依据. 方法 采用前瞻性队列研究,将入组的127例BPH患者随机采用耻骨上经膀胱前列腺摘除术(开放性手术组,55例)和经尿道前列腺切除术(TURP组,127例)进行治疗,并分别在手术后3、6、48个月进行随访观察.采用国际前列腺症状评分(IPSS)、BPH患者的生活质量专用量表(BPHQLS)评价不同时间各组患者的前列腺、生活质量状况.综合IPSS得分、生活质量得分、经济指标来综合评价不同手术方式的医疗后果. 结果 两组综合得分都呈曲线上升趋势,治疗前、手术3个月及6个月时两组的综合评分差异无统计学意义(均P＞0.05),48个月时开放性手术组(8.3±0.9)分、TURP组(7.6±0.8)分开放性手术组的医疗效果优于TURP组(P＜0.05). 结论 在治疗后3、6个月时两组的医疗效果相近,在48个月时开放性手术组综合的医疗后果优于TURP组.%Objective To synthetically evaluate medical treatment outcomes of two operative methods on benign prostatic hyperplasia (BPH),and to provide evidence for therapeutic regimen selection.Methods Prospective cohort study was applied.BPH patients were treated by two operative methods randomly,follow-up observations were carried out at 3 months,6 months,and 48 months after the treatment.IPSS and BPHQLS were adopted to evaluate prostate and quality of life of patients at different time.The weight coefficients of IPSS score,quality of life score and general hospitalization expense in the comprehensive evaluation were defined by the Delphi Method.Results The synthetic score of both groups showed ascending trend,comprehend evaluation of scores got after treatment for 3 months (OP group was 7.6±0.7,TURP group was 7.4±0.8),6 months(OP group was 6.9 ± 0.9,TURP group was 6.9 ± 1.1) showed no significant differences between two groups(P＞0.05),curative effect of OP group was better than TURP group at 48 moths(OP group was 8.3±0.9 score,TURP group was 7.6± 0.8 score) (P＜0.05).Conclusions The curative effect of OP group was better than TURP group at 48 months.